AAA92 Remarks

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    Introductory Remarks to Symposium on "Birth in Twelve Cultures: Papers in
                             Honor of Brigitte Jordan"

                Annual Meetings of the American Anthropological Association,
                          San Francisco CA, December 3, 1992

                                                            Brigitte Jordan

                                       Xerox Palo Alto Research Center and
                                        Institute for Research on Learning

                                                   Last Changes: 92.12.01
Abstract: Authoritative Knowledge and its Construction: Within any particular social situation a multitude of ways of knowing exist, but some
carry more weight than others. Some kinds of knowledge are discredited and devalued, while others become socially sanctioned, even
official, and are accepted as grounds for legitimate inference and action. In the hope of contributing to the design of better social and
technological support for people's activities during childbirth and otherwise, I explore the characteristics of settings, social arrangements, and
technologies that lead to particular distributions of authoritative knowledge and attendant decision-making power. (10 mins.)

I cannot begin to express to you how deeply I feel the honor you have accorded me with this
symposium. I am tremendously pleased to find assembled in one spot such a large number of
individuals who are all actively involved in the anthropological (in contrast to the medical) study of
birth. When I began investigating childbirth and midwifery in Yucatan (and I believe that is now
almost exactly 20 years ago), what we now know as the Anthropology of Birth or the field of
Ethno-Obstetrics did not exist.

There were a very few anthropologists who had ever even considered the topic in any systematic
way (there was a seminal survey article by Margaret Mead and Niles Newton which mostly
bemoaned the fact that there were no good ethnographic data on childbirth and some
crosscultural comparisons pulled out of the Human Relations Area Files). But there were few
anthropologists who considered the topic a legitimate topic in anthropology -- and even that is
saying too much. It wasn't that people argued is it or isn't it legitimate, it simply wasn't there.
Childbirth did not exist in anthropology.

There was no notion of birth as a cultural system; the idea of ethno-obstetrics (a term later coined
by Carol McClain) had not seen the light of day, nor the notion that western cosmopolitan
obstetrics could be studied in a comparative anthropological manner as just another ethno-

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obstetric system (an idea that Robert Hahn has been responsible for). Believe me, for a struggling
graduate student those were intellectually lonely days indeed.

So I am tremendously pleased to see how far we have come. The Anthropology of Birth is now a
lively and vital field and if I have contributed to its growth, I take great pleasure in that.

[I also take great pleasure in the republication of Birth in Four Cultures which truly would not have
happened without the labor of love bestowed on it by Robbie Davis-Floyd. The book has been
updated and revised. We also added three new chapters to it which contain some of my more
recent writings. ... none of which would have happened without Robbie's dedication.]

Now, I think I should also tell you that I no longer work in the area of childbirth. I've changed my
career, again, (I actually think it takes about ten years to make a dent in a given field), and after
having participated in illuminating, at least partially, the territory of childbirth, I felt I needed to
move on. In my current life I am trying to understand, together with my colleagues at Xerox PARC
and IRL, how people organize themselves to work together, play together, live together -- and
what we as anthropologists and social scientists can do to contribute to the design of better
working and learning environments.

So I have been less directly concerned with childbirth recently and have focused more on the
underlying, or I am tempted to say, overlying question of cultural change, and in particular the role
new kinds of artifacts and technologies play in that change. But while the shift from medical
anthropology to the anthropology of work may seem fairly radical, there are also some underlying
themes that have remained constant, and that actually have deepened in significance for me in
my exposure to industrial work settings. One of these is the notion of authoritative knowledge.

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There are two ways in which one might use the idea of authoritative knowledge:

•       one, the more conventional use, sees authoritative knowledge simply as the knowledge
that is attached to persons in authority positions, as, for example, the doctor in childbirth, the
teacher in the classroom, the foreman in a plant;

•       the second, and this is what I have been mostly concerned with, looks at AK as the
knowledge on the basis of which decisions are made in a given setting, by a given social group.

Let me tell you what I think the second use buys us.

One issue that arose for me very early on in my work came from the observation that in some
social situations multiple kinds of knowledge are present by virtue of the experience and
background of the various participants. In some groups, these different kinds of knowledge are in
conflict, in others, they become a resource for constructing a joint way of seeing the world, a way
of defining what shall count as authoritative knowledge.

This is the case, for example, in childbirth in Yucatan where women in the rural communities draw
on a large body of wisdom that is assembled in each particular birth from a shared history and
from the experience of those present, that is, the woman's immediate family, the village midwife,
and other experienced women in the community. What is interesting is that in such situations, all
participants lend a hand to give aid -- physical, emotional, ritual, spiritual -- and if the labor is
drawn-out and difficult, they build a shared store of knowledge through stories, demonstrations,
and remedies. In this manner, a joint view of what is going on in this labor, with this woman-plus-
baby, is constructed in which everybody involved in the birth shares.

In contrast to western medicalized births, there is no one in charge here. There is no single
decision-maker. It is certainly not the midwife (which was initially a surprise for me because I
expected her to act as some sort of doctor equivalent); it is not the woman, either (which was
something that I, as a feminist graduate student, would have loved to see). Rather, the store of
knowledge required for conducting a birth is created and recreated by all participants jointly as
they do the work of birthing.

What is interesting is that we have also found this horizontal distribution of authoritative
knowledge in our more recent work in high-technology work places. For example, when we

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studied the control center for an airline's ground operations, we found that the people who work
there are also constantly engaged in updating each other on the state of their world, where the
"world" at issue is the world of planes in the air, on the ground, and at the gates and their state of
readiness in regard to passengers, baggage, fuel, food and crews. In this situation information
coming into the room through any of a number of channels (such as printers, radios, telephones,
computer screens, video monitors) is potentially relevant to everybody in the room and we find
that information is not treated as privileged. People do not withhold information, they constantly
give and solicit help, and they develop shared work practices and technologies which support the
joint updating of the common stock of knowledge on the basis of which decisions are made in the

To be sure there are supervisors in the ops room. But for the routine work of getting planes in and
out they function not so much as controllers of information and decision-makers but as an extra
pair of hands, an extra set of vigilant eyes, somebody who can keep watch over a particular
problem as it develops and possibly link to outside resources if they are required. The routine
decisions are all made by the working team.

In contrast to the ops room, there are other situations where multiple kinds of knowledge donot
come together, where one kind of knowledge wins out and carries the day. This is typical for
American hospital births where medical knowledge supersedes and delegitimizes other potentially
relevant sources of knowledge such as the woman's prior experience and the knowledge she has
of the state of her body. Nonmedical knowledge is devalued by all participants, usually including
the woman herself who comes to believe that the course charted on the basis of professional
medical knowledge is the best for her. If she does not acquiesce and decides to actively resists,
we get, in the extreme case, the phenomenon of court-ordered cesarean sections, that is, the
legal enforcement of one particular kind of knowledge.

I've surely painted a one-sided picture here and things are by no means as black and white and
as uncomplicated and straightforward as I have made them out for the sake of a 10-minute

Maybe the question we might want to ask at this point, is: does this kind of analysis, i.e. an
analysis in terms of Authoritative Knowledge, give us any leverage for restructuring the shape of
birth in our own society. And I think it does. I think what we need to think about is how we can
move from a situation in which authoritative knowledge is hierarchically distributed, into a situation

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where it is, by consensus, horizontally distributed, i.e. where all participants in the labor and birth
contribute to the store of knowledge on the basis of which decisions are made.

In our technocratized systems we need to ask questions such as: What would have to happen for
the woman to truly become a part of the decision-making process? What if her knowledge, both
bodily and intellectual, were to be accorded legitimate status? What if she had a place in the
professional participation structures set up around the birth? Could there be a translation process
between what the woman knows and what the staff understand to be the situation? Could there
be a mutual accommodation of these divergent ways of knowing such that one single authoritative
knowledge structure emerges?

This, I believe is the challenge for the future of childbirth in the technologized western world as
well as in the developing countries of the Third World.

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